II. Indication

  1. Upper Gastrointestinal Bleeding risk stratification

III. Criteria

  1. Blood Urea Nitrogen (BUN)
    1. BUN 18.2 to 22.4 mg/dl (6.5 to 8 mmol/L): Score 2
    2. BUN 22.4 to 28 mg/dl (8 to 10 mmol/L): Score 3
    3. BUN 28 to 70 mg/dl (10 to 25 mmol/L): Score 4
    4. BUN >70 mg/dl (>25 mmol/L): Score 6
  2. Hemoglobin
    1. Men
      1. Hemoglobin 12 to 13 g/dl: Score 1
      2. Hemoglobin 10 to 12 g/dl: Score 3
      3. Hemoglobin <10 g/dl: Score 6
    2. Women
      1. Hemoglobin 10 to 12 g/dl: Score 1
      2. Hemoglobin <10 g/dl: Score 6
  3. Systolic Blood Pressure (SBP)
    1. SBP 100 to 109 mmHg: Score 1
    2. SBP 90 to 99 mmHg: Score 2
    3. SBP <90 mmHg: Score 3
  4. Miscellaneous Markers
    1. Pulse >100 per minute: 1
    2. Presentation with Melena: 1
    3. Presentation with Syncope: 2
    4. Hepatic disease: 2
    5. Cardiac failure: 2

IV. Interpretation

  1. Assesses probability for intervention (Blood Transfusion, endoscopy, surgery)
  2. Score 0
    1. Low risk for intervention
    2. Reasonable to manage as outpatient
  3. Score >0
    1. Increased risk for intervention and inpatient management is recommended
    2. However most cases <5 respond without signficant intervention
  4. Score >5
    1. High risk for intervention

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